Legal claims defining the scope of protection, as filed with the USPTO.
1. A computer integrated payment system directed to the care of a subject, said system comprising: a care planner, accessed via a computing device, for accurately approximating the costs for the subject during the course of care; an insurance verifier and estimator, accessed via a computing device, that identifies the portion of the costs for the course of care of the subject that is covered by the subject's insurance, wherein said approximated costs less the covered insurance leaves a subject payment; a discount planner, accessed via a computing device, that evaluates the application of at least one discount to the subject payment, wherein the at least one discount includes a prompt payment discount; and, a payment planner, accessed via a computing device, that enables a payment arrangement for the subject for the subject payment less any applied discounts, wherein increased functionality of the computer integrated payment system is achieved using automated integration of said care planner, said insurance verifier and estimator, said discount planner and said payment planner and providing the ability to communicate in and among at least two of said care planner, said insurance verifier and estimator, said discount planner and said payment planner, wherein, when prior to the subject being discharged from the course of care, said prompt payment discount is determined to be 10% when a balance of the subject payment is less than $1000.00, and 15% when the balance of the subject payment is equal to or greater than $1000.00; and when after discharge of the subject from the course of care, but within 30 days of said prompt payment discount being offered, said prompt payment discount is determined to be 5% when the balance of the subject payment is less than $1000.00, and 10% when the balance of the subject payment is equal to or greater than $1000.00.
2. The integrated payment system of claim 1 , wherein the verifier and estimator provides the ability to collect information about the insurance of the subject, enter the collected information into the system, and provide the underlying basis and result of the estimate of the insurance payment.
3. The integrated payment system of claim 2 , wherein the verifier and estimator operate in a feedback controlled environment.
4. The integrated payment system of claim 1 , wherein the verifier includes entering or collecting insurance information of the subject.
5. The integrated payment system of claim 4 , wherein entering or collecting insurance information of the subject includes determining information regarding the subject and payer and the details of each.
6. The integrated payment system of claim 1 , wherein the verifier includes verifying insurance based on the care plan.
7. The integrated payment system of claim 1 , wherein the verifier includes collecting cardholder information regarding the subject's insurance.
8. The integrated payment system of claim 1 , wherein the verifier includes determining at least one of coverage and benefits of health plan, visit limits, copays and other insurance information.
9. The integrated payment system of claim 1 , wherein the verifier includes verifying coverage based on the type of care that is determined to be administered under the care plan.
10. The integrated payment system of claim 1 , wherein the estimator includes determining the status of the service provider.
11. The integrated payment system of claim 10 , wherein determining the status of the service provider includes determining the in-network/out-of-network status of the service provider.
12. The integrated payment system of claim 1 , wherein the estimator includes coding treatments and diagnoses from the care plan.
13. The integrated payment system of claim 1 , wherein the estimator includes providing coding recommendations using proper coding principles that increase insurance coverage.
14. The integrated payment system of claim 1 , wherein the discount planner that evaluates the application of at least one discount to the subject payment applies said at least one discount to the payments based on a myriad of factors.
15. The integrated payment system of claim 1 , wherein the discount planner further includes at least one of insurance discounts, hardship discounts, and discounts associated with any health discount plans.
16. The integrated payment system of claim 15 , wherein the discount planner automates application of each applied discount and provides weighting and conditions for the application of each type of discount and applications of discounts as a whole.
17. The integrated payment system of claim 15 , wherein insurance discounts include any discount which a provider is required to apply as a matter of law or contract.
18. The integrated payment system of claim 15 , wherein hardship discounts include waiver of deductibles and co-pays.
19. The integrated payment system of claim 15 , wherein said waiver of deductibles and co-pays is based on one of poverty level and under insured analyses.
20. The integrated payment system of claim 15 , wherein said hardship discounts are designed to assist uninsured and underinsured patients that are unable to afford bills and cost-sharing amounts.
21. The integrated payment system of claim 15 , wherein said hardship discounts are in writing, based on objective criteria, and uniformly applied.
22. The integrated payment system of claim 1 , wherein said prompt payment discounts include discounts designed to reduce a provider's accounts receivables and costs of debt collection.
23. The integrated payment system of claim 1 , wherein the payment planner takes the care planner expected costs, the developed insurance payment portion, and after accounting for appropriately applied discounts develops a form of payment plan based on the balance for the subject.
24. The integrated payment system of claim 1 , wherein the payment planner includes sample payment arrangements based on pre-payment, time-of-service, and installment payment plans.
25. The integrated payment system of claim 1 , wherein the payment planner includes plans coordinated with monthly auto-debit transactions.
26. The integrated payment system of claim 1 , wherein the payment planner includes plans coordinated without monthly auto-debit transactions.
27. A method of achieving computer integrated payment system directed to the care of a subject, said method comprising the steps of: requesting contact information of the subject; enabling the subject and a provider to enter information into the system via a computing device, said information including at least one demographic data of the subject; prefilling at least one document within the payment system via a computing device; verifying the insurance of said subject via a computing device; developing a care plan for said subject via a computing device; estimating the insurance payment for the developed care plan of said subject via a computing device; applying at least one discount via a computing device to the payment for the developed care plan of said payment, wherein the at least one discount includes a prompt payment discount; and, determining an appropriate payment plan via a computing device for the cost of the developed care plan reduced by said estimated insurance payment and said applied at least one discount, wherein, when prior to the subject being discharged from the course of care, said prompt payment discount is determined to be 10% when a balance of the payment is less than $1000.00, and 15% when the balance of the payment is equal to or greater than $1000.00; and when after discharge of the subject from the course of care, but within 30 days of said prompt payment discount being offered, said prompt payment discount is determined to be 5% when the balance of the payment is less than $1000.00, and 10% when the balance of the payment is equal to or greater than $1000.00.
Unknown
February 8, 2011
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